A clinical variant of chancroid resembling granuloma inguinale.

Sixteen patients with nonsyphilitic genital ulcerations had the clinical features of granuloma inguinale. Biopsy specimens and Wright's-stained tissue crush preparations obtained from all patients failed to demonstrate Donovan bodies. Herpes simplex virus was absent in cultures obtained from 11 patients. However, when techniques for culturing Hemophilus ducreyi became available in the latter part of the study, this organism was isolated from seven of eight consecutively studied patients. The pathologic process, therefore, represents a variant of chancroid having the clinical features of granuloma inguinale. Without the widespread availability of culture techniques for isolating H ducreyi, diagnostic uncertainty between these two diseases may occur.

Pseudogranuloma inguinale caused by haemophilus ducreyi.

We used a new selective culture medium to isolate Haemophilus ducreyi from a penile ulcer that had the clinical appearance of granuloma inguinale. The isolation of the organism in pure culture permitted us to make a definitive diagnosis and obtain antimicrobial susceptibility data in a relatively short period. As a result, we were able to change therapy from sulfamethoxazole to erythromycin, and the infection rapidly healed.

Chronic urticaria from tantalum staples.

We report herein the onset of chronic urticaria ten months after surgical implantation of tantalum staples. Intradermal testing with tantalum an urticarial response. The urticaria did not improve by treatment with antihistamines, but responded dramatically to disulfiram chelation therapy and resolved completely after surgical removal of the tantalum staples. We suspected a type 1 anaphylactic hypersensitivity to tantalum was present, but we have also considered that tantalum might have direct histamine releasing-like activity.